Nokea
Which of the following causes is the most common cause for sudden cardiac death?
- A. Ventricular tachycardia
- B. Aortic stenosis
- C. Hypertrophic cardiomyopathy
- D. Angina
Correct Answer: A
Rationale: Acute ventricular dysrhythmias (e.g., ventricular tachycardia, ventricular fibrillation) cause the majority of cases of SCD. Less commonly, SCD occurs because of a primary left ventricular outflow obstruction (e.g., aortic stenosis, hypertrophic cardiomyopathy) or extreme slowing of the heart (bradycardia).
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The nurse is assessing a patient who has chest pain is to the emergency department and all the following diagnostic tests are prescribed. Which of the following tests should the nurse arrange to be completed first?
- A. Electrocardiogram (ECG)
- B. Computed tomography (CT) scan
- C. Chest x-ray
- D. Troponin level
Correct Answer: A
Rationale: The priority for the patient is to determine whether an acute myocardial infarction (AMI) is occurring so that reperfusion therapy can begin as quickly as possible. ECG changes occur very rapidly after coronary artery occlusion. Troponin levels will increase after about 3 hours. Data from the CT scan and chest x-ray may impact the patient's care but are not helpful in determining whether the patient is experiencing a myocardial infarction (MI).
The nurse is caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having percutaneous coronary intervention and the nurse obtains these assessment data. Which of the following data indicate the need for immediate intervention by the nurse?
- A. Pedal pulses 1+
- B. Heart rate 100 beats/minute
- C. Blood pressure 104/56 mm Hg
- D. Chest pain level 8 on a 10-point scale
Correct Answer: D
Rationale: The patient's chest pain indicates that restenosis of the coronary artery may be occurring and requires immediate actions, such as administration of oxygen and nitroglycerin, by the nurse. The other information indicates a need for ongoing assessments by the nurse.
The nurse is caring for a patient who was admitted the previous day to the coronary care unit with an acute myocardial infarction. Which of the following information should the nurse include in the teaching plan for the patient?
- A. Typical emotional responses to AMI
- B. When patient cardiac rehabilitation will begin
- C. Discharge drugs such as Aspirin and β-blockers
- D. The pathophysiology of coronary artery disease
Correct Answer: B
Rationale: Early after an AMI, the patient will want to know when resumption of usual activities can be expected. At this time, the patient's anxiety level or denial will prevent good understanding of complex information such as coronary artery disease (CAD) pathophysiology. Teaching about discharge medications should be done when the time for discharge is closer. The nurse should support the patient by decreasing anxiety rather than discussing the typical emotional response to myocardial infarction (MI).
The nurse is developing a health teaching plan for a 60-year-old man with the following risk factors for coronary artery disease (CAD). Which of the following risk factors should the nurse focus on when teaching the patient?
- A. Family history of coronary artery disease
- B. Increased risk associated with the patient's gender
- C. High incidence of cardiovascular disease in older people
- D. Elevation of the patient's serum low density lipoprotein (LDL) level
Correct Answer: D
Rationale: Because family history, gender, and age are nonmodifiable risk factors, the nurse should focus on the patient's LDL level. Decreases in LDL will help reduce the patient's risk for developing CAD.
The nurse is caring for a patient who has had severe chest pain for several hours and a diagnosis of possible acute myocardial infarction. Which of the following prescribed laboratory tests should the nurse monitor to help determine the diagnosis?
- A. Homocysteine
- B. C-reactive protein
- C. Cardiac-specific troponin
- D. High-density lipoprotein (HDL) cholesterol
Correct Answer: C
Rationale: Troponin levels increase about 3-12 hours after the onset of myocardial infarction (MI). The other laboratory data are useful in determining the patient's risk for developing coronary artery disease (CAD) but are not helpful in determining whether an acute MI is in progress.